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Histologic grading correlates with inflammatory biomarkers in tibialis posterior tendon dysfunction
Richard M Danilkowicz1, Selene G Parekh1, David M Tainter1
1Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710, United States.
Summary
Inflammation plays a role in tibialis posterior tendon dysfunction (TPTD). This study found elevated inflammatory markers and glutamate in diseased tendons, suggesting inflammation contributes to tendon degradation.
Area of Science:
- Orthopedics
- Biochemistry
- Pathology
Background:
- Tibialis posterior tendon dysfunction (TPTD) has been theorized as a degenerative, non-inflammatory process.
- Investigating the role of inflammation in TPTD is crucial for understanding its pathology.
Purpose of the Study:
- To determine if inflammatory cytokines, matrix metalloproteases (MMPs), and glutamate are elevated in diseased tibialis posterior tendons (TPTs).
Main Methods:
- Collected matched diseased TPT, TPT insertion, and flexor digitorum longus (FDL) samples from 21 patients.
- Analyzed samples for inflammatory cytokines, MMPs, and glutamate.
- Performed histology and statistical analyses.
Main Results:
- Diseased TPT and TPT insertion showed significantly elevated levels of eight inflammatory markers compared to control FDL tendons (p < 0.005).
- Glutamate levels were significantly higher in diseased TPT compared to FDL tendons (p < 0.01).
- Histologic grading correlated with inflammatory cytokine levels.
Conclusions:
- Elevated inflammatory markers in diseased TPT and TPT insertion suggest inflammation is involved in TPTD.
- The degree of inflammation correlated with increased tendon degradation, supporting an inflammatory role in the disease process.
